Prohibition on Delegation of Non-Emergency Medical Decision-Making in New Hampshire Parenting Plans

Introduction

This commentary examines the Supreme Court of New Hampshire’s decision in In the Matter of David Campbell and Robin Partello (No. 2023-0521), issued April 4, 2025. The appeal and cross-appeal arose from a final parenting plan entered by the Circuit Court, which allocated parenting time between David Campbell (Father) and Robin Partello (Mother), and delegated non-emergency medical decision-making to the child’s pediatrician. On appeal, the Supreme Court affirmed most aspects of the plan but held that the trial court erred by delegating medical decision-making to a third party. This case clarifies the limits of a New Hampshire court’s authority under RSA 461-A when allocating parental responsibilities.

Summary of the Judgment

After a final hearing, the trial court adopted a parenting plan heavily favoring Mother’s proposal—eight residential days every two weeks for Mother, the balance for Father—because it entailed less change from a prior temporary plan. The court also directed that “nonemergency medical decisions” (e.g., vaccinations) be “deferred to [the child’s] pediatrician in the first instance.” Father appealed on several grounds, including preservation of statutory-factor arguments, sufficiency of detail in the plan, and the allocation of parenting time. Mother cross-appealed the medical delegation provision and various trial-court rulings she chose not to seek relief for. The Supreme Court:

Affirmed the parenting time allocation and rejected Father’s statutory-factor and detail-deficiency claims as waived or unsupported.
Reversed the delegation of non-emergency medical decisions to the pediatrician, holding the statutes—RSA 461-A:5 & :6—do not authorize such delegation.
Declined to address Mother’s cross-appeal issues for which no relief was sought.
Remanded for modification of the medical decision-making provision.

Analysis

Precedents Cited

In the Matter of Morris & Morris, 174 N.H. 562 (2021): Established the broad discretion of trial courts in parenting matters and the “unsustainable exercise of discretion” standard of review.
In the Matter of Routhier & Routhier, 175 N.H. 6 (2022): Confirmed that credibility assessments and evidentiary weight lie within the trial court’s discretion.
In the Matter of Miller & Todd, 161 N.H. 630 (2011): Discussed the requirement to apply RSA 461-A:6 factors in parenting-plan decisions.
McDonough v. McDonough, 169 N.H. 537 (2016): Clarified that issues not raised in a motion to reconsider are waived on appeal.
In the Matter of Mannion & Mannion, 155 N.H. 52 (2007): Reviewed the allocation of decision-making responsibility under RSA 461-A and applied an unsustainable-discretion standard.
In the Matter of Kurowski & Kurowski, 161 N.H. 578 (2011): Held interpretation of trial-court orders is reviewed de novo.
In the Matter of Bordalo & Carter, 164 N.H. 310 (2012): Determined courts cannot award parental responsibilities to third parties against fit parents without constitutional justification.

Legal Reasoning

1. Standard of Review: The Supreme Court applied an unsustainable exercise of discretion standard to discretionary parenting determinations and a de novo standard to statutory interpretation and order construction.

2. Preservation of Issues: Father’s argument that the trial court failed to cite RSA 461-A:6 factors was not preserved: mere submission of proposed findings was insufficient, and the motion to reconsider did not raise the issue (McDonough).

3. Sufficiency of Plan Details: RSA 461-A:4 requires a plan to specify residential schedules and legal residences; RSA 461-A:6 requires best-interest findings. The plan met these requirements, and Father pointed to no mandatory omission.

4. Parenting Time Allocation: RSA 461-A:6(I-a) does not mandate equal time; courts consider any relevant best-interest factors (RSA 461-A:6(I)(m)). The trial court reasonably favored the plan minimizing transitions, confusion, and parental contact.

5. Delegation of Medical Decisions: Although RSA 461-A:5 & :6 authorize allocation of decision-making responsibility between parents, they do not empower a court to delegate those responsibilities to a third party (here, the pediatrician). This delegation exceeded statutory authority.

Impact

This decision clarifies key principles for New Hampshire family courts:

Trial courts lack authority under RSA 461-A to delegate non-emergency medical decision-making to non-parental third parties.
Parties must raise all statutory-factor arguments at trial or in a motion to reconsider to preserve them for appeal.
Parenting plans satisfying RSA 461-A:4 & :6—by specifying schedules, residences, and best-interest findings—are unlikely to be overturned absent an unsustainable exercise of discretion.

Future litigants and courts must ensure that decision-making allocations remain between parents or are explicitly authorized by statute, and that trial-court orders are drafted to reflect the proper parties as decision-makers.

Complex Concepts Simplified

Unsustainable Exercise of Discretion: A high bar for reversal; the appellant must show the court’s decision lacks any reasonable justification in the record.

De Novo Review: The appellate court gives no deference and decides the issue anew, typically used for statutory interpretation and order construction.

Preservation Requirement: Issues must be raised at trial or in a timely motion to reconsider, giving the trial court a chance to address them before appeal.

Parenting Plan Statutory Factors: RSA 461-A:6 lists numerous best-interest factors—such as stability, communication, and child’s preference—that a court may consider.

Conclusion

The Supreme Court of New Hampshire’s decision in Campbell & Partello affirms most discretionary determinations of the trial court, underscores the necessity of issue preservation, and, most notably, prohibits delegation of non-emergency medical decision-making to third parties under RSA 461-A. This ruling reinforces the statutory framework mandating that parents, not courts or other individuals, retain the authority to make crucial healthcare decisions for their children, unless otherwise provided by law.